NPI | 1720115710 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MD 2990) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 2990) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 2990) | |
103T00000X Psychologist (Licence: MD 2990) | |
Enumeration Date | 2007-02-27 |
Last Update Date | 2007-07-08 |